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September 1996
Volume 60 |
Number 9
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TO THE MEMBERSHIP
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| Pre-emptive Analgesia:
Variations on a Theme |
Erwin Lear, M.D.
Editor
As is customary, the September issue of the NEWSLETTER
dwells on historical matters of relevance to anesthesiology and
often medicine as a whole. It is especially fitting to consider
our past, since this October 16 will mark the 150th anniversary
of the first demonstration of the administration of ether for
a surgery at Massachusetts General Hospital.
On October 15, 1910, as reported in the Boston Medical and
Surgical Journal [1910; 163(24):893-904], George Washington
Crile, M.D., delivered an "address" on the occasion
of the 64th anniversary of "Ether Day." He set forth
his theory on "Anoci-association." Dr. Crile stated,
"The difference between anesthesia and anoci-association
is that although inhalation anesthesia confers the beneficent
loss of consciousness and freedom from pain, it does not prevent
nerve impulses from reaching and influencing the brain."
His concern was for the "fear, pain, shock and postoperative
neuroses" that often followed surgery. In order to obviate
the stated complications, his "anoci-association is accomplished
by a combination of special management of patients [applied psychology],
morphine, inhalation anesthesia and local anesthesia." It
seems that a preoperative visit, some premedication and local
anesthetic to the surgical site in addition to general anesthesia
provided the patient with an ideal postoperative course.
In the July 1996 issue of Anesthesiology, an article on
"Pre-emptive Analgesia" seems to have reinvented the
wheel.
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